HomeMy WebLinkAboutWickham's Fruit Farm - OFFICE OF THE TOWN CLERK . ' OFUL/re
Town of Southold
Judith T. Terry, Town Clerk .� ,
Town Hall, 53095 Main Road �
P. 0. Box 1179V,V':
Southold, New York 11971 p ` "r O�,
Telephone �_�.( i $""
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 388 Residential X
Fee $ 10.00 Non-Residential
- Septic Cesspool x
NAME OF OWNER: Wickham's Fruit Farm
OWNER MAILING ADDRESS: Box 928
Cutchogue, New Ydrk 11935
OWNER PROPERTY ADDRESS: Main Road (Private Road off Main Road)
Cutchoque, New York -
OWNER TELEPHONE NUMBER: 516-734-5637
TAX MAP NO. : Section 102 Block 6 Lot 20.1
CROSS STREET: Depot Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1986
Judith T. Ter
Southold Town Clerk
DATE: August 7, 1987
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- - (TOWN SEAL)
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OFFICE OF THE TOWN CLERK c0FO(I�
Town of Southold om® . Application No. 3fee
Judith T. Terry, Town Clerk - s"..�`� _ � ) Residential
Town Hall, 53095 Main Road c cry _
_ � ;'
P. O. Box 1179 •• Non-Residential
Southold, New York 11971 O ���•
Telephone 0l VP.°
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ / ®
DATE /-vC . i' 12
OWNER NAME: ('G4 4.-4 - 5 ; UI 0 • d-z
OWNER MAILING ADDRESS: 662--)( 91
C4,11 -1--c-L � .V1 ' / 4
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 57 73 '' hie 3 2
TAX MAP NO. : Section /69-2. Block 6 Lot 2.
CROSS STREET: L/Yti 2, --
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool ✓ New Existing
Residential Non-Residential
- DATE OF PREVIOUS PUMP-OUT: / -re
LOCATION MAP: Must be attached hereto before permit may be issued. -
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
its �
1111ignature of Applicant
RECEIVED BY•,orir,.
T.wn lerk's •ffice
DATE: AUG 071987
Town Clerk Southall
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